These events, reported separately in the media this week, are plainly linked. Let's get into the weeds: Sen. Herb Kohl (D-Wisc.) sent letters to AstraZeneca (AZN), Novartis (NVS), Sanofi-Aventis (SNY), GlaxoSmithKline (GSK), Eli Lilly (LLY) and Pfizer (PFE) asking them to explain why they charge so much more for their drugs in America than they do in the U.K., Canada, France and other industrialized nations. Americans spend $878 per person on prescriptions, compared with $446 in costs for foreigners, Kohl says. Some examples:

The short answer is that America, unlike any other industrialized nation, does not have a proper, modern healthcare system that exercises leverage on drug prices on behalf of consumers. Instead it relies on the free market and some government programs to provide a patchwork of coverage that has many holes. That patchwork is bad at negotiating lower drug prices -- so we end up paying more than everyone else.

Congress may fill some of those holes this week if it can get President Obama's healthcare reform bill passed, but even then it would be mendacious to call the result a "system."

Abandonment is up 68 percent since 2006 for brand name drugs. That's not just uninsured people who decide they can't afford the medicine they need: 14.4 percent of all prescriptions go unfilled because of a combination of "abandonment" and insurance companies denying coverage. Average copays rose $5 in 2009 to $31 (up from $26 in 2006).

Wolters has some offensive language to describe this problem:

"Today, patients wield more power and are more inclined to exert that influence in decisions about their prescription drugs," said Mark Spiers, President & CEO, Wolters Kluwer Pharma Solutions. "During tough economic times, consumers tend to think more with their pocketbooks. We're seeing increasing price-sensitivity to co-pay, and bolder moves by patients in making decisions about their drug therapy ..."

"What's peculiar is that the rate of increase among patients walking away is almost unprecedented," Belasi told MM&M.

There's nothing peculiar about it. It's the least mysterious phenomenon in the drug business today: As drug prices rise, and healthcare coverage rates decline, and Congress fails to pass a reform bill, there will be an increase in both insured and uninsured people deciding they don't have the money for the medicine they need.